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UNIFORM HAZARDOUS <br />WASTE MANIFEST <br />I Generator 10 Number 2 Page 1 of 3 Emer perry Rnsporise Phone <br />CA C 0 0 3 1 7 3 7 7 8 2.- 1-800-899-4672 "trot Te1921r7 3 7 G BF <br />Ci-RPlEps <br />6540 S. AUSTIN RD <br />3TOCKTON CA 85215 <br />2 0 9 5 0 7 - 2 8 9 <br />rkL JOI-it+19 •:0!-1 ('Fth (1.^•re''19a 4d,'"'" rl <br />;st .21VONMENTALSERVICESINC. <br />US EPA tD Number <br />CAR000030114 <br />7 Transporter 1 Company Name <br />ecC4.24 <br />c <br />C Y IL'ikOtk <br />H(GI-MAY 95, 11 MILES SOUTH OF BEATTY <br />BEATTY NV 89003 <br />Pho,,e 800 239-3943 IN V T 3 3 0 0 1 0 0 0 0 <br />1 EPAID Ntribw <br />lAfikret 774/:? e-78 <br />US ETA frf Number <br />10 Continers it Tots <br />Cluantly <br />12 Und <br />MI <br />13 Waste Codes <br />Type No <br />00200 0 0 1 TP <br />9b US 001 Desaetion (ndudeg Proper Shipping Name Hazard Class ID Number, <br />Fip,4 and Padung Group (of any)) <br />2 Non7FICIR—A Hizirdous Vsaste Solid ( PM & DEBRIS) <br />CiN1824, WkSTE Sodium hydroxide solution <br />8. PGII 0002 141 <br />352 <br />0 0 7 01000 <br />4 <br />Speciii Handl ng instNcbons and Addbonai information <br />1 . ) u70137710-21816 <br />2.) 070128300-27921 <br />Job# 178203 PO# 178203-SANCHEZ-05.11.22 <br />DE.xpod trom us 16 Intornatonal St 'moments amporl to U S <br />Trst spoiler signature (for exports only) <br />' 5 GENERATOR'S/OFFERORS CEIMFICATION: I hereby declare that the contents of this consignment are futh and accurately described above by the proper shipping name. ard ere detained. packaged. <br />marked std labeled/placarded. and are vial respects ,n proper condbcci for transport acoircing to appecable aternaboni and national governmental regulations If export sNprrent and 1 am the Pnmary <br />Ecuador. I cerbfy that the contents of this consignment conform to the terms of the attached EPAAcknothedgment of Consent <br />I certify that the waste Ruination statement idenehed in 40 CFR 2E2_27(a) 611am charge quantity (Will am a Sly celeriac) is <br />P:TL N,44x, "sire ivrc vPrvitr, <br /> <br />111 (4q 47A.24.4 <br />Port of entry/exit <br />Date leaving US <br />r. Day 67, <br />t 3: <br />S vibre <br />1 Parbal Reectern <br />US. EPA ID Number <br />Manifest Reference Number <br />, !I iliardows VYaste Report Management Wend Codes (h I., codes for hazardous waste treatment disposal, and recycling systems) <br />j <br />.: i)6-1 <br />I I) 12 <br /> <br />F)/ <br />..1 0csi9 weed Facet) Owner or Operator Catlin/kr a recent of hazardous malenabi covered by the mandril except as (loud in hen lila _ _ <br />- ..,I AT_ WI Tr: , <br />lyc Signalure of Allemale Fad ty (or Generator) <br />idb A teMa-te Facility (or Generator) <br />Ii Transporter Acknowledgment of Receipt of Matinee <br />Y.; Prtac:Sin Nur, <br />- <br />JL <br />U sarpancy <br /> <br />lttj Discrepancy Induban Space Wetly <br />.LA .1)1A/1/1tA <br />EPA Form 8700-22 (Rev 1217) Pt u bitty its are obsolete <br />I Type OResidue <br />SWAP, <br />/r/lIr <br />Month Day <br /> <br />I° I / / <br />n <br />wILIZ.2122.1 <br /> <br />I 1 Full Rejection <br />Month Day Year <br />S <br />; 10 LP/0; t-hitOkNit-t-V JUtt GENERATOR z OLSIGNATED FACILITY Form Aare/a/1 OMB No 2050-0039